Technique for repair of vesicorectal fistula; does not require diverting colostomy in mechanically and antibiotically prepped bowel. Patient is placed in prone position with buttocks reflected and taped laterally. Sagittal incision is made from posterior anal verge to coccyx with separation and tagging of muscle layers (including complete thickness of posterior rectal wall) for correct reapproximation. Fistula is then excised with separate closures of bladder and rectum (2-layered closures) and overlying muscle fibers reapproximated.